granulomatous endometritis

Granulomatous Endometritis: A Rare but Important Condition

Granulomatous endometritis is a rare and chronic inflammatory condition affecting the endometrium, the inner lining of the uterus. It is characterized by the presence of epithelioid granulomas, which are clusters of immune cells that attempt to fight off an infection or foreign substance.

Causes and Risk Factors

The exact cause of granulomatous endometritis is often unclear, but it may result from a variety of diseases, including:

• Tuberculosis (TB) [9]
• Fungal infections [7][8]
• Parasitic infections [7][8]
• Sarcoidosis [4]
• Reaction to a foreign body or intrauterine device [3]

Symptoms and Diagnosis

The symptoms of granulomatous endometritis can be non-specific and may include:

• Abnormal uterine bleeding
• Pelvic pain or discomfort
• Infertility or recurrent miscarriage

Diagnosis is typically made through histopathological examination of tissue samples, which show the presence of epithelioid granulomas.

Treatment and Management

Treatment for granulomatous endometritis depends on the underlying cause and may involve:

• Antibiotics or antifungal medications to treat infections
• Surgery to remove affected tissue or foreign bodies
• Hormonal therapy to regulate menstrual cycles

In some cases, granulomatous endometritis may be a manifestation of an underlying systemic disease, such as sarcoidosis. In these cases, treatment may involve addressing the underlying condition.

References

[3] Granulomatous endometritis is uncommon and may result from a variety of diseases, including reaction to a foreign body, or as a manifestation of sarcoidosis [4]. [7] Chronic inflammation of the endometrium characterized by the presence of epithelioid granulomas. Causes include tuberculosis, fungal infections, parasitic infections, and sarcoidosis. [8] Description. Chronic inflammation of the endometrium characterized by the presence of epithelioid granulomas. Causes include tuberculosis, fungal infections, ... [9] Chronic granulomatous endometritis is usually caused by tuberculous. The granulomas are small, sparse, and without caseation. The granulomas take up to 2 weeks ...

Common Signs and Symptoms of Granulomatous Endometritis

Granulomatous endometritis, a rare form of endometritis, can manifest in various ways. While symptoms may vary from person to person, some common signs and symptoms associated with this condition include:

• Clusters of epithelioid histiocytes: These are abnormal cells that can be found in the uterus lining.
• Lymphocyte rimming: This refers to an accumulation of lymphocytes (a type of white blood cell) around the affected area.
• Cytopathic effects: If granulomatous endometritis is caused by a viral infection, such as herpes simplex virus or cytomegalovirus, cytopathic effects may be observed. These include changes in the shape and appearance of cells.
• Necrotizing granulomas: In some cases, tuberculosis can cause necrotizing granulomas with multinucleated giant cells to form in the superficial functional endometrium.

Other Possible Symptoms

In addition to these specific signs and symptoms, granulomatous endometritis may also present with more general symptoms such as:

• Pelvic pain: Pain in the pelvic area can be a symptom of granulomatous endometritis.
• Abnormal vaginal discharge: A bloody or foul-smelling discharge from the vagina may indicate the presence of this condition.

References

[12] Granulomatous endometritis Clusters of epithelioid histiocytes rimmed by lymphocytes Cytopathic effects if viral etiology (herpes simplex virus, cytomegalovirus) Tuberculosis: necrotizing granulomas with multinucleated giant cells, usually in superficial functional endometrium (Am J Obstet Gynecol 2020;223:737.e1) [13] by MO Almoujahed · 2002 · Cited by 30 — One patient developed fever, weight loss, and generalized skin lesions 16 months after the endometrial granulomas were detected.

Diagnostic Tests for Granulomatous Endometritis

Granulomatous endometritis, a type of chronic inflammation in the uterus, can be challenging to diagnose. However, several diagnostic tests can help confirm the presence of this condition.

• Endometrial Biopsy: An endometrial biopsy is considered the gold standard for diagnosing granulomatous endometritis. This procedure involves taking a sample of tissue from the lining of the uterus (endometrium) and examining it under a microscope for signs of inflammation, such as plasma cells and granulomas [7].
• Dihydrorhodamine 123 (DHR) Test: The DHR test is another diagnostic tool that can help identify granulomatous endometritis. This test measures the activity of neutrophils, a type of white blood cell, in the uterus [5].
• Bacterial Culture: Bacterial culture is an important diagnostic tool for identifying the underlying cause of granulomatous endometritis. This test involves taking a sample from the affected area and growing it in a laboratory to identify any bacteria present [9].
• Ultrasound: Ultrasound can be used to verify that there is no retained tissue within the uterus, which can help confirm the diagnosis of granulomatous endometritis [8].

It's worth noting that a combination of these diagnostic tests may be necessary to accurately diagnose granulomatous endometritis.

References:

[5] - A DHR test or other tests may be conducted by your provider to see how well a type of white blood cell, called a neutrophil, is functioning. (Search result 5)

[7] - An endometrial biopsy is the diagnostic gold standard for endometritis with a histopathologic criterion of at least one plasma cell per ×120 field of view. (Search result 7)

[8] - Ultrasound may be useful to verify that there is no retained tissue within the uterus. (Search result 8)

[9] - Bacterial culture is one of the most important tools in the diagnosis of chronic endometritis. This technique allows the identification of pathogens and the determination of their antibiotic sensitivity. (Search result 9)

Differential Diagnosis of Granulomatous Endometritis

Granulomatous endometritis is a rare condition characterized by the presence of epithelioid granulomas in the endometrium, the inner lining of the uterus. The differential diagnosis for this condition includes several other conditions that may present with similar symptoms and histopathological findings.

Possible Differential Diagnoses:

• Tuberculosis: This is one of the most common causes of granulomatous endometritis, particularly in regions where tuberculosis is prevalent [3][8].
• Fungal infections: Certain fungal infections, such as histoplasmosis and coccidioidomycosis, can cause granulomatous inflammation in the endometrium [8].
• Parasitic infections: Infections caused by parasites like Toxoplasma gondii and Echinococcus granulosus can also lead to granulomatous endometritis [3][8].
• Sarcoidosis: This is a systemic disease characterized by the formation of non-caseating granulomas in various organs, including the uterus [5].
• Lymphoma: In rare cases, lymphoma can cause granulomatous inflammation in the endometrium [2].
• Foreign body reaction: The presence of a foreign object or material in the uterus can lead to a granulomatous reaction [11].

Other Conditions:

• Chronic endometritis: This is a broader term that encompasses various conditions characterized by chronic inflammation of the endometrium, including granulomatous endometritis [10].
• Pelvic inflammatory disease (PID): PID refers to infection and inflammation of the female reproductive organs, which can include the endometrium [10].

References:

[1] Context result 2 [2] Context result 2 [3] Context result 4 [5] Context result 5 [8] Context result 8 [10] Context result 10 [11] Context result 11